These researchers audited records from 1,554 annual child health records that included quality of care data from 74 remote, rural and urban primary health care services throughout Queensland, the Northern Territory, South Australia and Western Australia participating in Australia’s Audit and Best Practice for Chronic Disease (ABCD) programme (a continuous quality improvement programme) between 2012 and 2014. All services completed the Systems Assessment Tool (SAT), developed in 2005 as a way for indigenous health services to assess their health care systems and improve their quality of care. The analysis sought to determine whether an association exists between social and emotional wellbeing, anaemia and child neurodevelopment process of care indicators (PoCIs) for young indigenous children (aged between 3 months and 14 years at the audit date) and (i) primary health care service and child characteristics, and (ii) organisational health service structures. Approximately onethird (32%) of the records had a social and emotional wellbeing PoCI, over half (56.6%) had an anaemia PoCI and almost half (49.3%) had a child neurodevelopment PoCI. When adjusted logistic regression models were fitted to the data and clustered for health services, it was found that children aged 12–23 months were significantly more likely to receive all PoCIs compared with children aged 24–59 months. The analysis also revealed that certain items in the SAT delivery system design component were associated with the process of care provided for anaemia: every 1-point increase in assessment scores for team structure and function (aOR 1.14; 95% CI, 1.01 to 1.27) and care planning (aOR 1.14; 95% CI, 1.01 to 1.29) items increased the odds of having an anaemia PoCI by 14%. In contrast, system assessment scores were not associated with social and emotional wellbeing PoCIs or child neurodevelopment PoCIs.
